Malpractice insurance crisis? Send in the nerds

HAS THE BLAME game spun totally out of control in Annapolis? Has government moved to the point of paralysis on any issue you might want to suggest? Seems like it.

Right now, they're blaming the actuaries.


You know who they are. They're the green-eyeshade guys who calculate how many of us will live long enough to collect all of the pension money we're owed and how many will go to the other side of the grass with money still in our accounts. The people who die early insure the people who live longer.

Calculations of this sort matter to insurance companies - and to the political leaders of Maryland these days, because actuaries are giving them ominous news.


Malpractice insurance premiums are so high that doctors, particularly those who deliver babies, have an increasingly hard time staying in their line of work.

So political leaders are asked to step in. Politics is all about motherhood, you will recall. It's less and less about problem-solving. It's more and more about scoring political points or doing the bidding of some interest group or other.

Gov. Robert L. Ehrlich Jr., Senate President Thomas V. Mike Miller and House Speaker Michael E. Busch should be the problem-solvers. They're asked to respond with some urgency to the actuaries' news by convening a special session of the General Assembly to pass emergency legislation. But what sort of legislation should it be? A state bailout of sorts? Lower maximums on malpractice awards by the courts? A new structure for reviewing the claims? (Some states have better systems than Maryland's: Indiana, for example.)

Or we could challenge the accuracy of the actuarial estimates, a modern version of the flat Earth approach.

Which brings us to the joke portion of our program.

How can you tell who's the extroverted actuary?

Answer: He's the one who stares at your shoes when he's speaking with you instead of his own shoes. You know, like, he's a more outgoing nerd.

Actually, we revere these men of numbers. They're making a lot of things work, including the aforementioned insurance companies. If you don't know how much coverage will cost over time, you don't know how much to charge the pool of people you're covering.


All this adding and subtracting now suggests that insurance costs for obstetricians, up 28 percent last year, must go up another 41 percent this year. That's 69 percent over two years. Doctors say they are giving up obstetrics because the insurance costs - $100,000 a year is a frequently cited figure - are beyond affordability.

The cost is up because the court judgments paid are way up: The average claim paid by Medical Mutual Liability Insurance Society of Maryland in the first quarter of this year was $412,000 - up from $386,000 last year and $234,000 in 2000, according to its CEO, David L. Murray.

It's not the actuaries' fault, of course. They're just the messengers. We could shoot them, which is a tradition. We could also try to understand. Mr. Murray says actuaries can't turn lead into gold. They're clever, he says, but people seem to think insurance companies can pay out more than they take in.

Last year, various parties investigated the actuaries' call for higher insurance premiums. The state's actuaries and outside consultants said the 28 percent request was justified. The picture has worsened since then.

So, problems like this one are why politicians get the big bucks. And now they're not earning their keep. Governor Ehrlich doesn't want to pass the costs along to the taxpayers - a reasonable, if debatable, position. Senate President Miller doesn't want to put more restraints on trial lawyers, the men who take the cases to court for injured patients - also legitimate.

Speaker Busch wonders when there'll be any serious discussion of the issue. Eureka! Worth a try.


As with slot machines and the ongoing budget deficit and the outdated tax system, medical malpractice insurance has fallen outside the arena of problem-solving in Maryland.

Blame everyone but the nerds.

C. Fraser Smith is news director for WYPR-FM. His column appears Sundays.